Acne is the most common skin problem in the United States. Up to 50 million people in the U.S. have it. It often appears as an outbreak of pimples on your face. But it can also show up on your chest, neck, back, or shoulders.
While you can cover a rash on your chest or arm with clothes, it's hard to hide bumps and blemishes on your face. Plus, they can be painful. They can affect your mood and make you self-conscious.
What Causes Acne?
Acne happens when a pore gets clogged with oil and dead skin cells. It can affect people of all ages. The main trigger for acne is fluctuating hormones -- specifically, the male hormone testosterone. (Women do have some levels of testosterone.) When teenagers hit puberty, their hormones start surging -- and often, so does acne.
The hormonal fluctuations that cause acne are most common during the teen years, but they can also affect adults. Women may have hormonal swings during their menstrual cycle, pregnancy, and menopause that result in acne breakouts.
Acne can also be a side effect of certain medications, such as anticonvulsants and steroid drugs. Some people may also have a genetic predisposition to acne. One study found that 50% of adults with acne had a parent, sibling, or child with acne.
Does What You Eat Make Acne Worse?
A generation or so ago, it was thought that eating too many sweet or greasy foods caused acne. Now doctors know much more about why breakouts happen and how to treat them.
There is some evidence that certain diets may have an effect on acne, says Macrene Alexiades-Armenakas, MD, PhD, an assistant clinical professor of dermatology at Yale School of Medicine. Studies, such as one published in the Journal of the American Academy of Dermatology, have suggested that consuming a lot of dairy products raises the risk of getting acne because of the hormones in milk, cheese, and yogurt. But later studies have not supported the theory.
How Is Acne Treated?
There are treatments that can help. The trick is finding what works best for you. It depends on factors such as your age, whether you’re male or female, how bad your acne is, and how long you’ve had it, among other things.
Treating acne on your own
Benzoyl peroxide is the first product many people try, because it’s pretty easy on the skin. Typically, you’ll start with a lower strength no matter what medicine you use. This helps you get used to it. Your doctor can tell you if it’s time to try a higher strength or to switch to something different.
Be patient. It can take weeks to see results from any medication. Your acne may look worse before it gets better. Don’t be surprised if you get redness, burning, or dry skin from your acne medicines. If it’s serious, call your doctor.
You may need to try several different medicines before you find what works best for you.
While a pimple will eventually go away, if you have outbreaks often, the skin problem that brings them on typically won’t go away by itself. And if you don’t treat it, you could end up with scars.
A skin doctor (dermatologist) can help. They might suggest a cream, lotion, gel, or soap that contains ingredients that can help. Many can be bought without a prescription:
- Aldactone (Spironolactone) blocks excess hormones and is available through prescription.
- Adapalene (Differin) stops pimples from forming under the surface of the skin.
- Benzoyl peroxide kills bacteria and removes extra oil
- Clascoterone (Winlevi) is a prescription topical treatment that blocks hormones that cause acne
- Resorcinol is an exfoliant to help unclog blackheads and whiteheads.
- Salicylic acid keeps pores from getting clogged.
- Sulfur removes dead skin cells.
For more serious acne, your doctor may prescribe:
You may need a combination of oral medicine and a cream or lotion. Don’t stop using your treatments if your skin clears. Stick with it until the doctor tells you to stop. This can help keep acne from coming back.
What are some other kinds of acne treatments?
Along with oral medication, lotions, and creams, your doctor may also suggest:
- Laser or other therapies that use light to treat blemishes
- Chemical peels to remove dead skin cells
- Surgical removal of large cysts that can’t be treated with medicine
- Cyst injections with anti-inflammatory cortisone
These treatments can be done in the doctor’s office or as an outpatient at the hospital.
Some people use natural treatments like tea tree oil (works like benzoyl peroxide, but slower) or alpha hydroxy acids (remove dead skin and unclog pores) for their acne care. Not much is known about how well many of these treatments work and their long-term safety. Many natural ingredients are added to acne lotions and creams. Talk to your doctor to see if they’re right for you.
Be Good to Your Skin
Wash the area two times a day. Use a gentle cleanser, not soap. Don’t scrub too hard.
Or try cleansing wipes. These already have cleanser in them and are easy to use, then throw away.
Other skin tips:
- Don’t use too much topical acne medicine -- apply just enough to cover problem areas.
- Many acne medicines (benzoyl peroxide, salicylic acid, and tretinoin) make your skin more sensitive to the sun.
- Don’t use oily makeup, sunscreen, or hair products.
- Don’t pick at or squeeze your pimples.
- Keep your hair, hands, and phone off your face.
For men, shaving can irritate your skin and make acne worse. Try an electric razor, or be very careful with a blade.
Will Your Acne Ever Go Away?
Most often, acne will go away on its own at the end of puberty, but some people still struggle with acne in adulthood. Almost all acne can be successfully treated, however. It’s a matter of finding the right treatment for you.